Prior Authorization is the process of getting written approval from Quartz for
specific services, equipment, and supplies before they are received. 

Prior Authorization

Prior authorization allows members to budget for upcoming expenses and avoid unexpected costs. During the prior authorization review, Quartz can alert members to non-covered services, visit limits, and other important requirements of their health plan.

Prior Authorization determines and authorizes payment:

  • A specific health service, Durable Medical Equipment (DME), or supply that is medically necessary
  • A specific number of visits or period of time during which care will be provided
  • A specific provider rendering the service

Prior Authorization lists are not all-inclusive and may differ depending on health plan type. Your benefit plan determines coverage.

Please contact Customer Service at (800) 897-1923 or call (608) 775-0234 / (888) 775-0234 (Trane members only) with specific code information to determine if an item or service is covered and requires prior authorization.

Failure to obtain Prior Authorization may result in non-coverage for the service or supply. Prior authorization is not a guarantee of payment.

This health plan is underwritten by Gundersen Health Plan, Inc.